Compare & Buy Car, Bike and Health Insurance Online - InsuranceDekho
Claim, renew, manage & moreLogin

All About Pre-Existing Coverage In Health Insurance Plans?

Updated On Sep 08, 2022

A pre-existing illness is defined as an illness or medical condition that the insured had before acquiring health insurance is referred to as a pre-existing condition. According to IRDAI, a condition is considered pre-existing if the insured had it diagnosed up to 48 months prior to purchasing the insurance. All chronic medical diseases, such as high blood pressure, thyroid problems, and diabetes, are considered pre-existing conditions. such as asthma.

All About Pre-Existing Coverage In Health Insurance Plans?

Pre-Existing Conditions Waiting Time

After a waiting time, the majority of health insurance policies cover pre-existing conditions. Any claim submitted for the treatment of a pre-existing condition will be denied by your insurance company during this time. Pre-existing disease waiting periods often last between two and four years.

All health plans do not have the same waiting period for pre-existing conditions. While some health insurance plans offer a two-year waiting period for diseases, other health insurance plans may cover the same disease after a four-year wait. It is advised that you change to a new insurance company only when your waiting period is over.

Tips On Purchasing Health Insurance If You Have A Condition 

People with pre-existing conditions frequently need to get a pre-policy medical exam before they may purchase medical insurance. The insurance company's premium will be based on the findings of the medical examination. Pre-acceptance health examinations may also result in the insurer's refusal to sell the policy or a reduction in the policy's coverage.

Even if you have a pre-existing condition, the following helpful advice can still help you discover the best health insurance plan:

  • Pre-Existing Disease Coverage Can Be Accessed After 48 Months

Having a pre-existing ailment can make it difficult to obtain health insurance. The most recent IRDAI standards, however, only allow health insurance firms to look at the past 48 months of medical history when determining whether a patient has a pre-existing condition. As a result, 48 months after your pre-existing ailment was discovered or treated, you can get health insurance that covers pre-existing conditions.

  • Don't Cover Up A Pre-Existing Condition

Avoid concealing any pre-existing medical conditions from your insurance provider when you are purchasing the policy. This is crucial because the insurer may deny your health insurance claim if your pre-existing condition is disclosed at the time of treatment.

  •  Every Visit To The Doctor Does Not Constitute A Pre-Existing Disease

Health insurance providers only assess long-term conditions when determining whether you have a pre-existing disease. Therefore, do not worry if you frequently get the flu, a cough, a cold, or a fever. Because they don't have long-term impacts, short-term health difficulties won't be taken into account as pre-existing conditions by the insurance provider.

  • Select A Medical Plan With A Shorter Ped Waiting Period.

There is a pre-existing sickness waiting period that prevents you from making a claim for a predetermined amount of time, regardless of whether you purchase an individual health plan or a family health insurance plan. Any claim made for these disorders during this time period will be denied by your insurance provider.

Additionally, the length of the waiting period may vary depending on the insurance policy. The duration and severity of your underlying illness also have a role. As a result, you ought to select a health insurance plan with a shorter waiting period for pre-existing conditions.

  • Steer Clear Of Health Plans That Require Co-Payments 

There may be a co-payment requirement for coverage of pre-existing conditions with some health insurance companies. In accordance with this provision, you will be required to contribute a portion of the claim amount during claim settlement, and the insurer will cover the remaining balance. However, not all health insurance policies include this co-payment provision for covering pre-existing conditions. Consequently, purchase a health plan without a co-payment provision.

Conclusion

Therefore, you are still eligible for health insurance coverage even if you have a pre-existing condition. Just be sure to verify your health insurance's pre-existing disease waiting period.

Also read: Health Insurance Plans For Women

Health Insurance Plans For Critical Illness

Disclaimer

This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

Health Insurance Coverage Calculator

Who do you want to insured ?

  • Individual
  • Couple
  • Family
  • Parents

Age of eldest insured member ?

Where do you live ?

Metro
Non-Metro
Disclaimer : Actual Coverage might vary basis your location, age and number of members

Best Health Insurance Plans In India

  • Cover 5 L
    Starting at 832/month*
    No room rent limit 100% no claim bonusUnlimited restoration benefits3 years PED waiting period
    View All Features
  • Cover 10 L
    Starting at 739/month*
    No room rent limit Unlimited restoration benefits50% no claim bonus4 Years PED Waiting period
    View All Features
  • Cover 5 L
    Starting at 447/month*
    No room rent limit 33% no claim bonus100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 1,312/month*
    No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting period
    View All Features
  • Cover 5 L
    Starting at 448/month*
    Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting period
    View All Features
  • Cover 5 L
    Starting at 664/month*
    No room rent limit 20% no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 675/month*
    No room rent limit 50% no claim bonusUnlimited restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 690/month*
    Single Private A/C Room 100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 546/month*
    Twin sharing room Zero no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 566/month*
    No room rent limit 20% no claim bonus100% restoration benefits3 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 1,770/month*
    Zero no claim bonusNo restoration benefits1 year PED waiting period
    View All Features
  • Cover 40 L
    Starting at 62/month*
  • Cover 2 L
    Starting at 146/month*
  • Cover 5 L
    Starting at 806/month*
    Single Private Room 10% no claim bonus100% restoration benefits2 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 476/month*
    60% no claim bonus150% restoration benefits4 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 526/month*
  • Cover 5 L
    Starting at 855/month*
    25% no claim bonus100% restoration benefits4 years PED waiting period
    View All Features
  • Cover 5 L
    Starting at 448/month*
    Single Private A/C Room 20% no claim bonus100% restoration benefits1 year PED waiting period
    View All Features
  • Cover 5 L
    Starting at 396/month*
    No room rent limit Room rent upto 2% of SI Room rent upto 1% of SI No room rent limit
    View All Features
  • Cover 5 L
    Starting at 738/month*
    No room rent limit 50% no claim bonus100% restoration benefits3 yrs PED waiting period
    View All Features
Note: Premium is shown for 18yr old individual of Delhi
Show More
Must BuyMust Buy

Why to Buy Health Insurance Policy Online from InsuranceDekho

  • Tax benefit upto 75,000*
  • Claim support everyday 10AM-7PM
  • 66 Lacs+ happy customers